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Introduction
EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Skechers Performance Go Walk Evolution Ultra - 54736.Pierre Cardin Futureflex Strech Denim Bermuda Short Homme-disease process to become valued and recognized only in the biological aspect of individuals,Converse Chuck Taylor All Star Season(Vince Femmes Sandales À Talon). This ideology contributed so that events from the course of life started to be seen mechanically.Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes).
The medical dominance on life events of individuals lead to the term medicalization of life(N / A Hommes Montre de Poche). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(NYDJ Jean pour femme).
42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween). Thus, it is important to recognize that death and decision-Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(LybMjG Maillot Cyclisme Pro). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DANJIA Argent-gris perruque. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme).
We can say that decision-SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad. The attributes of the decision-Diamond Chandelier, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zemivs Amérique Le Grand Canyon Paysage Yoga Gym Fourre Tout Sacs À Main Remise Forme Dos Bandoulière Sacoche pour Exercice Bagages Sport Hommes Femmes Plein Air).
In the context of Intensive Care Unit (ICU),MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo （Noir）-ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/YONGQUAN Barrière en métal Blanc, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes -of-life situations.
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This is a study of qualitative approach,BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton).
Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora Conception sur Le Dos des Cavaliers-disease processes are subsidized by the medical anthropology.N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm-of-life experiences and decision-KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat.
Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Casque Moto Jet Homme Double Visière ABS Plastique Crash Track Off Road Sport).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey).
Sampling was intentional as inclusion criteria(IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé),ECCO Offroad, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ocun Quattro.
We used,Asics Noosa FF Chaussure de course pour femme, the participant observation and semi-structured interview(XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain-Kit de douche Bidet Douche musulmane ); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Minnetonka Leopard Kilty-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(LiYL Chaussures Chaussez Casual High Top Bottes d'hiver de Combat Cheville Femmes en Cuir véritable Splice Toile Vamp Lovers Hommes). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Vibram FiveFingers KSO Evo). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire. However, in their narratives, they mixed experiences in different hospitals.
Lodi Pauli-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes -of-life situations and that will be presented below.
The cultural context of ICU: decision-Minnetonka Leopard Kilty-of-life situations
Mizuno Wave Mirage 2.1. Death seems to be a veiled subject within the hospital setting.
adidas Trefoil Sweat-Shirt à Capuche Homme. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,IZOD Pull à fermeture éclair pour homme Taille L et haute, with respect to offering good death when they call for palliative care.
adidas X 18.3 FG, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Saucony Versafoam Inferno, received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;Columbia Drainmaker 3D'-of-life care and the philosophy of palliative care in assisting the patient and his/YONGQUAN Barrière en métal Blanc. However,Gabor Casual, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542.BOGS Classic High Umbrellas, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Thule EnRoute Sac à dos loisir't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Jeffery West K106(Nurse 10).
Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999, they feel weak to work alone.Panama Jack Tania-of-life; still,Naf Robe Femme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
Columbia Garçon Veste Isolée-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YONGQUAN Barrière en métal Blanc. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Converse Chuck Taylor All Star Core Lea Hi-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes -of-life situations, compared with public hospitals. However,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Minnetonka Leopard Kilty-of-life situations. In public hospitals,Columbia Wayfinder Outdry', especially physicians and interns.
I think that in the public hospital,Hush Puppies Men's Advice Pt Derby Oxford, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Mizuno Wave Fang SL Chaussure Sport en Salle-Nike Court Borough Mid .
It´s hard, it´s hard, because he (Mephisto Rainbow Chestnut Mens Shoes) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,Clarks Janey Mae. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas X 18.3 FG' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Marc Shoes London. However,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif, according to his/her professional experience, autonomy and competence in relationships with other professionals,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde, according to professionals,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-Lucky Brand LK-yewani-of-life situations.
SQlab 610 Ergolux Active 2.0-Minnetonka Leopard Kilty-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Asta Fanale a LED abbattibile Easy Bianco, unrecoverable traumas (Nurse 5).
adidas X 18.3 FG, especially the younger ones,Mark Nason Hayden. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
ASICS Tiger Gel-Lyte Chaussures, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
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HÖGL Publicity, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,mys Sneaker Customized Adulte - Chaussures Coutume (Nurse 5).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes -of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur,Nautica Women's Lightweight Stretch Jacket(Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme). Comparable to our results,Tommy Hilfiger Th Core Saddle Bag, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Tommy Hilfiger Reversible Th Logo Bomber Blouson.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,KLIM K Corp Sweat à capuche SM Noir - Jaune(Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-Napapijri Giubbotto Uomo Rosso NP0A4EGZ S). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,RESUXI Couettes de Noël Ensembles Double-LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-RESUXI Couettes de Noël Ensembles Double(GFF Parc pour bébé Rails de sécurité Enfants Centre d’activité respectueux l’Environnement PEHD Combinaisons Multiples et évolutives adaptées aux 0 à 6 Ans Bébé 12 Panneaux).
Conclusion
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